Search

Aims The aim of this systematic review was to establish the efficacy of brushing with and without a dentifrice for dental plaque removal. Materials and Methods MEDLINE-PubMed, Cochrane- CENTRAL, EMBASE and other electronic databases were searched. The inclusion criteria were randomized controlled trials and controlled clinical trials and subjects ≥18 years of age with good general health. Studies that evaluated the effect of toothbrushing with a dentifrice compared to brushing without a dentifrice were included. Data were extracted from the eligible studies, and a meta-analysis was performed where feasible. Result The search was conducted until June 2016 and retrieved 10 eligible publications that included 20 comparisons. On average, 49.2% of plaque was removed when brushing was performed with a dentifrice, and 50.3% of plaque was removed when toothbrushing was performed without a dentifrice. The descriptive analysis indicated that the majority of the comparisons did not show an additional effect of dentifrice use. Regarding the meta-analysis of post-brushing scores, no significant difference was observed between toothbrushing with and without a dentifrice (DiffM 0.00, 95% CI [−0.05: 0.05], p = 0.91). The meta-analysis of incremental data (as means or percentages) supported and strengthened these findings. Conclusion The cumulative evidence for this systematic review demonstrates that there is moderate certainty that toothbrushing with a dentifrice does not provide an added effect for the mechanical removal of dental plaque. [ABSTRACT FROM AUTHOR]

Aim This randomized controlled trial assessed the impact of Lactobacillus reuteri on pregnancy gingivitis in healthy women. Materials and Methods Forty-five healthy women (24 test/21 placebo) with pregnancy gingivitis in the third trimester of pregnancy were enrolled. At baseline Gingival Index ( GI) and Plaque Index (PlI) were assessed at the Ramfjord teeth and venous blood taken for TNF- α analysis. Subsequently participants were randomly provided with lozenges to be consumed 2 × daily until birth (approx. 7 weeks) containing ≥108 CFU L. reuteri ATCC PTA 5289 and ≥108 CFU L. reuteri DSM 17938 (test) or being devoid of L. reuteri (placebo). Within 2 days after birth recording of GI, PlI and blood sampling were repeated. Results At baseline, mean GI and mean PlI did not differ significantly between both groups. In the test group mean TNF- α serum level was significantly ( p < 0.02) lower than in the placebo group. At reevaluation, mean GI and mean PlI of the test group were both significantly ( p < 0.0001) lower than in the placebo group. Mean TNF- α serum level did no longer differ significantly between the groups. Conclusions The consumption of L. reuteri lozenges may be a useful adjunct in the control of pregnancy gingivitis. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the correlation between bleeding on marginal probing (BOMP) and bleeding on pocket probing (BOPP), and the correlation of both bleeding indices with plaque. Materials and Methods: This cross-sectional study screened 336 participants, from which 268 were eligible for examination and analysis. Bleeding and plaque indices were assessed by single examiners, at six sites per tooth. Results: The mean percentage of sites per individual with bleeding on marginal probing, bleeding on pocket probing and dental plaque were 19.9%, 51.2% and 32.2% respectively. In the quadrants where the margin was probed before the pocket, a 4.6 percentage points higher bleeding tendency with BOPP was observed (p < 0.05). At a site level, the correlation coefficients of plaque and bleeding on marginal probing and bleeding on pocket probing were 0.19 and 0.20 respectively. Both bleeding indices were also shown to be correlated (r = 0.89, fixed effect model). Conclusion: The prevalence of bleeding upon probing is influenced by the scoring method that is used for the diagnosis. Probing the bottom of the pocket results in significantly more bleeding than running a probe along the margin. [ABSTRACT FROM AUTHOR]

Aim This 4-week, single-centre, randomized, examiner-blind, controlled study investigated the efficacy and safety of 0.15% ethyl lauroyl arginate ( LAE)-containing mouthrinse in adults with mild-to-moderate gingivitis. Material and Methods Subjects were randomized to use 0.15% LAE-containing mouthrinse or 5% hydroalcohol-negative control twice daily after brushing with standard fluoride toothpaste. Plaque, gingivitis and bleeding were assessed at baseline and Weeks 2 and 4. The oral microflora was analysed at baseline and Week 4. Results Eighty-seven subjects were randomized to treatment. The 0.15% LAE-containing mouthrinse was associated with statistically significantly ( p < 0.001) greater reductions in mean plaque and gingivitis scores versus the negative control at Week 2 (difference [95% confidence interval]: plaque 0.83 [0.64, 1.02], 29.1%; gingivitis 0.11 [0.07, 0.14], 4.8%) and Week 4 (co-primary endpoints: plaque 1.23 [1.07, 1.39], 42.6%; gingivitis 0.23 [0.19, 0.28], 10.7%). Bleeding-index scores were significantly ( p < 0.001) reduced versus the control at Weeks 2 (by 0.04 [0.03, 0.06], 36.3%) and 4 (by 0.06 [0.04, 0.08], 50.9%). No shifts were detected in the oral microflora. There were no treatment-related adverse events. Conclusions The 0.15% LAE-containing mouthrinse was well tolerated and significantly reduced plaque, gingivitis and bleeding when used as an adjunct to tooth brushing for 4 weeks. [ABSTRACT FROM AUTHOR]

Objectives To examine the existing evidence in identifying risk indicators in the aetiology of peri-implant mucositis. Material and Methods A search was performed in PubMed, Web of Science ( WOS) and The Cochrane Library databases for articles published until June 2014. Results This search gave 3135 results of which 15 studies fulfilled the inclusion criteria. The current review revealed that only a few studies provided data on risk indicators for the development of peri-implant mucositis. Based on the data available, there is evidence that plaque is a risk indicator for peri-implant mucositis. Smoking has also been identified as an independent risk indicator whereas the overall evidence for surface roughness, residual cement, the dimension of the keratinized tissue and time of implant in function is weak. There are limited data available to support systemic conditions as risk indicators for peri-implant mucositis. Conclusions Plaque accumulation at implants will result in development of peri-implant mucositis. Smoking should also be considered as a risk indicator for the development of peri-implant mucositis. [ABSTRACT FROM AUTHOR]

Aim The aim of this systematic review was to evaluate the efficacy of anti-plaque chemical formulations for managing gingivitis, in 6-month, home-use, randomised clinical trials ( RCTs). Material and Methods A protocol was designed, including inclusion and exclusion criteria to identify RCTs assessing gingival and/or bleeding indices. Electronic and hand-searches identified relevant papers, which were screened and evaluated for inclusion. Full-papers were retrieved and relevant information was extracted (also plaque indices), including quality and risk of bias. Mean treatment effects were calculated to obtain weighted mean differences ( WMD) and 95% confidence intervals. Results After the process of screening and selection, 87 articles with 133 comparisons, were included in the review. The additional effects of the tested products were statistically significant in terms of Löe & Silness gingival index (46 comparisons, WMD −0.217), modified gingival index ( n = 23, −0.415), gingivitis severity index ( n = 26, −14.939%) or bleeding index ( n = 23, −7.626%), with significant heterogeneity. For plaque, additional effects were found for Turesky (66 studies, WMD −0.475), Silness & Löe ( n = 26, −0.109), and plaque severity ( n = 12, −23.4%) indices, with significant heterogeneity. Conclusion Within the limitations of the present study, formulations with specific agents for chemical plaque control provide statistically significant improvements in terms of gingival, bleeding and plaque indices. [ABSTRACT FROM AUTHOR]

Aim The aim of this study was to assess whether oral hygiene-related self-efficacy is correlated with current oral hygiene and might influence the outcome of oral hygiene instruction. Materials and Methods Hundred and twenty-six patients filled out questionnaires about oral hygiene-related self-efficacy, general self-efficacy, oral hygiene-related knowledge and demographic variables. Plaque and gingival inflammation were measured and an individual oral hygiene plan was conducted. After 6 months, oral hygiene indices were assessed again. Results Women had significantly higher scores in oral hygiene-related self-efficacy than men (women mean 60.40 ± 9.41; men mean 56.04 ± 11.55; p = 0.039) and oral hygiene-related self-efficacy was significantly correlated with general self-efficacy independent from the age of the patients ( r = 0.3114, p = 0.0004). Higher scores in oral hygiene-related self-efficacy were significantly correlated with lower scores of gingival bleeding for non-smoking patients ( r = −0.301, p = 0.0066), usage of a professional tooth cleaning within these 6 months ( p = 0.0406), reappearance to the follow-up appointment ( p = 0.0303), and higher goals in inter-dental cleaning plans ( p = 0.0189). Conclusion Oral hygiene-related self-efficacy is an influencing factor in the oral hygiene behaviour and has the potential to predict patients' oral hygiene outcomes. [ABSTRACT FROM AUTHOR]

Aim To systematically evaluate the efficacy of chlorhexidine ( CHX) mouthrinses on plaque, gingival inflammation and staining in gingivitis patients. Material & Methods Medline, EMBASE and Cochrane Central Register of Controlled Trials were searched through April 2011. Randomized controlled clinical trials comparing CHX to placebo/control mouthrinses or oral hygiene ( OH) ≥4 weeks were included. Results Among 1355 titles, 30 publications fulfilled the selection criteria. Meta-analysis ( MA) showed significant weighted mean differences ( WMD) favouring CHX. This was −0.39 [95% CI: −0.70; −0.08] for the Plaque Index Silness & Löe, −0.67 [95% CI: −0.82; −0.52] for the Plaque-Index Quigley & Hein ( PIQH), −0.32 [95% CI: −0.42; −0.23] for the Gingival Index ( GI), −0.08 [95% CI: −0.10; −0.05] for the bleeding aspect of the GI, −0.21 [95% CI: −0.37; −0.04] for the Papillary BIeeding Index, −0.16 [95% CI: −0.26; −0.07] for Bleeding on Marginal Probing and 0.91 [95% CI: 0.12;1.70] for the Lobene Stain Index. MA of studies with a low risk of author-estimated bias showed a WMD of −0.68 [95% CI: −0.85; −0.51] for the PIQH and −0.24 [95% CI: −0.29; −0.20] for the GI in favour of CHX. Relative to control, the reduction with CHX for plaque was 33% and for gingivitis 26%. CHX rinsing groups demonstrated significantly more staining. Conclusions In gingivitis patients, CHX mouthrinses together with OH versus placebo- or control mouthrinse provide significant reductions in plaque and gingivitis scores, but a significant increase in staining score. [ABSTRACT FROM AUTHOR]

The article discusses a study about the periodontal status and determine the relationship among socio-economic position (SEP), plaque accumulation, tobacco smoking and periodontitis. Researchers examined a stratified sample of 254 35-44 year old adults in Jerusalem who were given a clinical examination and self-administered questionnaire. Based on the results, there is a potential explanatory pathway for the relationship between SEP and severe chronic periodontitis (SCP).

Background: Chlorhexidine (CHX) rinsing after periodontal surgery is common. We assessed the clinical and microbiological effects of two CHX concentrations following periodontal surgery. Materials and methods: In a randomized, controlled clinical trial, 45 subjects were assigned to 4 weeks rinsing with a 0.05 CHX/herbal extract combination (test) or a 0.1% CHX solution. Clinical and staining effects were studied. Subgingival bacteria were assessed using the DNA-DNA checkerboard. Statistics included parametric and non-parametric tests (p<0001 to declare significance at 80% power). Results: At weeks 4 and 12, more staining was found in the control group (p<0.05 and p<0.001, respectively). A higher risk for staining was found in the control group (crude OR: 2.3:1, 95% CI: 1.3 to 4.4, p<0.01). The absolute staining reduction in the test group was 21.1% (9 5% CI: 9.4-32.8%). Probing pocket depth (PPD) decreases were significant (p<0.001) in both groups and similar (p=0.92). No rinse group differences in changes of bacterial counts for any species were found between baseline and week 12. Conclusions: The test CHX rinse resulted in less tooth staining. At the study endpoint, similar and high counts of periodontal pathogens were found. [ABSTRACT FROM AUTHOR]

Berchier CE, Slot DE, Van der Weijden GA. The efficacy of 0.12% chlorhexidine mouthrinse compared with 0.2% on plaque accumulation and periodontal parameters: a systematic review. J Clin Periodontol 2010; 37: 829–839. doi: 10.1111/j.1600-051X.2010.01575.x. Objectives: The aim of this systematic review was to evaluate the effects of 0.12% chlorhexidine (CHX) mouthrinse compared with 0.2% on plaque and periodontal parameters. Materials and methods: MEDLINE-PubMed and the Cochrane Central Register of Controlled Trials were searched for (randomized) clinical trials and cohort studies. Plaque scores, parameters of periodontal inflammation and periodontal attachment loss were selected as primary outcome parameters. Results: Screening of 409 titles and abstracts identified eight eligible publications. A meta-analysis of seven studies using the same plaque index showed a significant difference between 0.2% and 0.12% CHX ( p=0.008). The Weighted Mean Difference for plaque based on the Quigley & Hein Plaque Index (1968) was 0.10 (95%CI [0.03–0.17]) (heterogeneity I2=0%, p=0.87). Three studies that compared 0.12% and 0.2% CHX mouthrinse products provided data on gingival inflammation. No difference in the effect of gingivitis between the two concentrations was found in these studies. No studies could be found that compared the two CHX concentrations and evaluated the probing pocket depth and/or the periodontal attachment level. Conclusions: In comparing 0.12% and 0.2% CHX, information concerning the effect on gingival inflammation was sparse and no studies could be found that compared the two CHX concentrations and evaluated the probing pocket depth and/or the periodontal attachment level. With respect to plaque inhibition, the results showed a small but significant difference in favour of the 0.2% CHX concentration. However, the clinical relevance of this difference is probably negligible. [ABSTRACT FROM AUTHOR]

Aim: To monitor the intra-oral microbiological changes after full-mouth extraction using quantitative polymerase chain reaction (qPCR). Material and Methods: Nine patients with severe, aggressive periodontitis, for whom a full-mouth tooth extraction was the only remaining treatment option were recruited. Before and 6 months after extraction, microbial samples were obtained (tongue, saliva and subgingival plaque) and analysed by qPCR. Results: The elimination of subgingival niches, by extraction of all natural teeth, resulted in a 3-log reduction of Porphyromonas gingivalis and Tannerella forsythia, and more modest reductions of Aggregatibacter actinomycetemcomitans and Prevotella intermedia. However, the detection frequencies of these periodontopathogens in saliva and on the tongue remained unchanged after full-mouth tooth extraction. Conclusion: In contrast to what has been believed so far, full-mouth tooth extraction does not result in eradication of all periodontopathogens but only in a significant reduction. The clinical consequences of this observation remain speculative. [ABSTRACT FROM AUTHOR]

Objectives: Evaluate the efficacy and safety of an experimental toothbrush with a slow-release system of chlorhexidine (CHX) and determine its ability to inhibit plaque, bleeding, staining and oral tissue abnormalities during 6 weeks of use. Material and Methods: One hundred and fifty healthy volunteers were randomly assigned to one of three groups: the Test Brush group with a template slow-delivery system of CHX (Ttb), the Control Brush group without CHX (Ctb) and the Control Brush group without CHX but rinsing post-brushing with a 0.2% CHX mouthrinse (Ctb+R). At baseline as well as at 3 and 6 weeks, all clinical parameters were assessed. Following the baseline assessment, a supragingival prophylaxis was provided. Results: One hundred and forty subjects completed the study. The Ctb+R group had lower plaque and bleeding scores than the Ttb and the Ctb group and significantly ( p=0.0001) higher stain scores. There were no significant differences in plaque, bleeding and stain scores between the Ttb and the Ctb group. No differences were detected in oral tissue changes, except for discoloration of the tongue. Conclusions: In the present study, no beneficial effect could be demonstrated for the experimental CHX-releasing toothbrush. The use of a 0.2% CHX mouthrinse (in combination with brushing) remains the gold standard for additional chemical plaque control. [ABSTRACT FROM AUTHOR]

Aims: The aim of this split-mouth study was to investigate levels of tumour necrosis factor alpha (TNF- α), transforming growth factor beta (TGF- β2) and interleukin-1 beta (IL-1 β) in gingival crevicular fluid (GCF) and peri-implant crevicular fluid (PICF) after a 21-day-period of de novo plaque accumulation in the same patient. Material and Methods: In 25 patients, samples of GCF and PICF were collected in the sulcus of the tooth and of the implant after professional hygiene. After the no-hygiene phase (21 days), second samples of GCF and PICF were taken. Third samples were collected after 69 days of re-establishment oral hygiene techniques. The crevicular fluids were used to determine the volume and the levels of TNF- α, TGF- β2 and IL-1 β. Results: The volume of the crevicular fluids increased significantly after 21 days of plaque accumulation around teeth and implants and decreased significantly by 69 days. TNF- α and TGF- β2 did not change significantly among the three different samples. A significant increase of IL-1 β was observed after plaque accumulation around the teeth GCF, whereas in the PICF the increase was not statistically significant. Conclusions: These data suggest that increased volumes of GCF and PICF could be useful markers of early inflammation in gingival and peri-implant tissues. In the presence of de novo plaque, implants showed lower, and nearly significant, levels of IL-1 β compared with teeth. [ABSTRACT FROM AUTHOR]

Aim: To compare effects of three cetylpyridinium chloride (CPC) formulations with and without alcohol and Tween80 on physico-chemical properties of salivary pellicles, bacterial detachment in vitro and bacterial killing in vivo. Material and Methods: Adsorption of CPC to salivary pellicles in vitro was studied using X-ray photoelectron spectroscopy and water contact angle measurements. Adhesion and detachment of a co-adhering bacterial pair was determined in vitro using a flow chamber. Killing was evaluated after live/dead staining after acute single use in vivo on 24- and 72-h-old plaques after 2-week continuous use. Results: The most pronounced effects on pellicle surface chemistry and hydrophobicity were observed after treatment with the alcohol-free formulation, while the pellicle thickness was not affected by any of the formulations. All CPC formulations detached up to 33% of the co-adhering pair from pellicle surfaces. Bacterial aggregate sizes during de novo deposition were enhanced after treatment with the alcohol-free formulation. Immediate and sustained killing in 24 and 72 h plaques after in vivo, acute single use as well as after 2-week continuous use were highest for the alcohol-free formulation. Conclusions: CPC bioavailability in a formulation without alcohol and Tween80 could be demonstrated through measures of pellicle surface properties and bacterial interactions in vitro as well as bacteriocidal actions on oral biofilms in vivo. [ABSTRACT FROM AUTHOR]

Objectives: To study the outcome of intensified mechanical oral hygiene compared with the effect of an adjunctive antibacterial mouth rinse on plaque and gingivitis in elderly people. Material and Methods: In a randomized, single-blind, 6-month controlled clinical study, 106 subjects, 55 years or older, were divided into four groups: (I) Participants were instructed on improved mechanical oral hygiene, including interdental hygiene; (II) subjects used an antibacterial mouth rinse containing amine and stannous fluoride in addition to their usual oral hygiene practices; (III) both intensive mechanical and antibacterial measures were combined; and (IV) a control group with no specific regimen. Gingivitis and plaque were examined. Results: After 6 months, both plaque and gingivitis scores were significantly lower than at baseline in all groups. Reductions in gingivitis differed significantly between the control group and all other groups but not between the three intervention groups. Only groups with improved mechanical oral hygiene showed significant improvements in plaque scores compared with control. Conclusions: Intensive mechanical oral hygiene resulted in greater plaque reduction than the combination of an antibacterial rinse and usual oral hygiene procedures. Gingivitis was reduced by both intensive oral hygiene and use of the amine/stannous fluoride rinse. Combining intensive mechanical oral hygiene with the antibacterial rinse did not result in further gingivitis reduction. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to investigate in vivo the influence of aged, resin-bonded, ceramic restorations on approximal dental biofilm formation and gingival inflammatory response, associated with and without customary oral hygiene. Material and Methods: In a cross-sectional and in a 10-day experimental gingivitis study, Quigley–Hein plaque index, gingival index (GI), crevicular fluid and its levels of interleukin (IL)-1 α, -1 β and receptor antagonist were measured at appoximal surfaces of leucite-reinforced bonded ceramic coverages, resin composite restorations and enamel and compared intra-individually in 17 participants. Results: No differences were found between the ceramic, composite and enamel regarding plaque index, GI, levels of IL-1 α, -1 β and the receptor antagonist. Throughout, higher crevicular fluid amounts were observed at ceramic sites compared with the enamel ( p<0.05). In the experimental gingivitis, plaque index, GI, crevicular fluid and its IL-1 α levels increased significantly. Conclusion: The need for optimal oral hygiene and professional preventive oral health care does not seem to be reduced with regard to approximal surfaces of aged, resin-bonded, leucite-reinforced ceramic restorations in comparison with those of a hybrid, resin composite and enamel. [ABSTRACT FROM AUTHOR]

Aim: To compare the periodontal conditions of Swiss Army recruits in 2006 with those of previous surveys in 1996 and 1985. Material and Methods: A total of six hundred and twenty-six Swiss Army recruits were examined for their periodontal conditions, caries prevalence, stomatological and functional aspects of the masticatory system and halitosis. In particular, this report deals with demographic data, the assessment of plaque index (PlI), gingival index (GI) and pocket probing depth (PPD). Results: Two per cent of all teeth were missing, resulting in a mean of 27.44 teeth per subject, and 77% of the missing teeth were the result of pre-molar extractions due to orthodontic indications. The mean PlI and GI were 1.33 and 1.23, respectively. On average, 27% of the gingival units bled on probing. The mean PPD was 2.16 mm (SD 0.64). Only 3.8% of the recruits showed at least one site of PPD⩾5 mm, and 1.4% yielded more than one site with PPD⩾5 mm. In comparison with previous, this survey yielded lower bleeding on probing (BOP) percentages than in 1985, but slightly higher scores than in 1996. This may be attributed to increased PlI scores in 2006. However, PPD remained essentially unaltered from 1996 to 2006 after having improved significantly from 1985. Conclusion: A significant improvement of the periodontal conditions of young Swiss males was demonstrated to have taken place between 1985 and 1996, but no further changes during the last decade were noticed. [ABSTRACT FROM AUTHOR]

Objective: This review searched for a relationship between susceptibility to periodontitis and peri-implantitis, with implant outcome as the primary outcome variable and supportive periodontal therapy (SPT) and implant surface roughness as confounding factors. Material and Methods: It is based on a MEDLINE search up to June 2006. Only 16 fulfilled the selection criteria. The heterogeneity of the studies (e.g. periodontal status, SPT, prosthetic design, ...) rendered a meta-analysis impossible. The impact of a history of periodontitis on early implant loss was negligible. Only five papers reported sub-data for patients with different degrees of periodontitis. Four out of five papers indicate a higher incidence of late implant loss and/or marginal bone loss in patients with a history of periodontitis. This difference was most obvious for very rough implants (three papers), and/or when SPT was not organized (one paper). Other confounding factors were often neglected. Another 10 papers only reported the outcome of implants in patients with a history of periodontitis. In case of SPT and when avoiding roughened surfaces, late implant loss remained below 3%, and marginal bone loss remained low. Conclusions: These results seem to indicate that periodontally compromised patients can be successfully treated with minimally/moderately rough implants, in the presence of SPT. [ABSTRACT FROM AUTHOR]

Aim: The aim of the study was to determine the plaque and gingivitis reducing effect of a dentifrice containing chlorhexidine and aluminium lactate compared with a control toothpaste during the course of 6 months. Material and Methods: This randomized, double-blind study looked prospectively at participants over a 6-month period. Plaque, gingivitis, calculus formation and tooth staining were assessed in 59 participants, who were divided into parallel groups. The participants used either a chlorhexidine and aluminium lactate-containing toothpaste (test group) or a minus active control toothpaste (control group). Parameters were assessed at baseline and again after 1, 3 and 6 months. Results: After 6 months of product use, both groups had less gingivitis compared with the baseline evaluation ( p<0.001). At this time point, the test group showed a statistically significant lower gingival index values compared with the control group ( p=0.001). No statistically significant differences between either the groups or time points were detected with regard to plaque index and the development of calculus and staining. Conclusion: Although there was a statistically significant difference at 6 months between test and control groups, this difference was too small to be considered clinically meaningful. [ABSTRACT FROM AUTHOR]

Aim: To investigate, by means of multilevel analysis, factors that may affect the short-term clinical outcome of non-surgical periodontal treatment. Materials and Methods: Forty-one patients randomly assigned to two protocols of non-surgical therapy were included. The impact of different covariates on the probability of “pocket closure” [i.e. probing pocket depth (PPD)⩽4 mm] was explored using a logistic multilevel model. The impact on the final PPD was explored using a continuous multilevel model. Results: The logistic model revealed a significant impact of smoking ( p<0.001), presence of plaque at the site ( p<0.001) and location of the pocket at a multi-rooted tooth ( p<0.001). The model explained 44% of the total variability. Of the unexplained variance, 19% was attributed to inter-patient variability. The continuous model revealed the same factors to be significant and an additional significant impact of interactions between the covariates. The R2 was 0.50 and the random slopes model revealed an increase in the variability of the final pocket depth with an increase in the initial PPD. Conclusion: Smoking habits, plaque at site level and tooth type were significant factors in determining the short-term clinical outcome of non-surgical periodontal treatment. [ABSTRACT FROM AUTHOR]

Aim: To evaluate, in young adults, the effect of different preventive programmes on oral hygiene and to determine whether the variables investigated are predictors of gingival health. Material and Methods: This randomized, blinded, parallel, controlled clinical study examined the effectiveness of three dental health programmes. Four hundred subjects aged 20–27 years, 211 males and 189 females, participated in the study. They were recruited from a Public Dental Service clinic and from a private dental practice in Jönköping, Sweden. The effect of the programmes on plaque and gingivitis was evaluated over a 3-year period. The programmes included activities that were adapted for individuals as well as for groups. The plaque indices (PLI) and gingival indices (GI) were used to evaluate the programmes. Results: All programmes resulted in a decrease in PLI and GI. The greatest decrease was found in the group that was followed-up every 2 months. Professional tooth cleaning was non-significant for the clinical result. Gingival health at baseline, participation in any of the test programmes, and knowledge of the dental diseases caries, gingivitis or periodontitis were significant predictors of good gingival health. Conclusions: The study confirms the efficacy of three different preventive programmes in reducing supragingival plaque and gingival inflammation. Professional tooth cleaning provided no clinical benefit beyond that derived from individual and group-based health education. [ABSTRACT FROM AUTHOR]

Aim: The objective of this study was to monitor prospectively clinical parameters in subjects without signs of destructive periodontal disease who were involved in a primary prevention programme, and to determine the changes that occurred between yearly examinations over a 3-year period. Material and Methods: One hundred and twenty-six subjects aged at least 20 years with a maximum of two tooth sites with probing pocket depth (PPD)>4 mm and no proximal sites with clinical attachment loss participated in the study. Primary prevention was provided at baseline of the study and then every 6 months. Plaque, bleeding on probing (BoP) and PPD were scored at baseline, 1, 2 and 3 years. Results: There were no significant changes in the plaque score over the 3 years. After year 1, the BoP score was significantly improved with 5.6%, while no further improvement in BoP was found at years 2 and 3. The mean PPD decreased from 2.3 to 2.1 mm over the 3 years ( p<0.05). Conclusion: Although some individuals exhibiting minor signs of periodontal pathology may have benefited from the primary prevention, the overall clinical improvement was limited for such subjects in the present 3-year study. [ABSTRACT FROM AUTHOR]

Background: Delmopinol is a third-generation anti-plaque agent used as a mouthwash to reduce plaque and alleviate gingivitis. Objective: To create an overview of the anti-plaque efficacy of 0.2% delmopinol as an adjunct to normal oral hygiene measures by meta-analysis of completed clinical trials. Materials and Methods: Eight double-blind, parallel-group studies were identified. Study durations ranged from 8 to 24 weeks. Five studies ( n=913) involved supervised rinsing; three studies ( n=467) involved unsupervised rinsing. These sets of trials were analysed separately and in combination. Efficacy outcomes comprised modified plaque index, modified gingival index (MGI) and gingival bleeding on probing (BOP). Results: Delmopinol 0.2% was superior to placebo for the reduction of plaque scores in both sets of studies. Effects on MGI and BOP were also better with delmopinol 0.2% than with placebo. In most instances, 95% confidence intervals were wholly in favour of delmopinol. Pooled analysis of all eight studies confirmed statistically significant effects of delmopinol 0.2% compared with placebo ( p<0.00001). Delmopinol met the efficacy criteria of the American Dental Association in studies of extended duration. Conclusion: Delmopinol 0.2% mouthwash is effective as an adjunct measure for reducing plaque burden and indices of gingivitis, whether or not it is used under supervision. [ABSTRACT FROM AUTHOR]

Aim: To study longitudinal associations between plaque and gingival bleeding and multilevel variance/covariance structures after introducing triclosan-containing toothpaste. Material and Methods: A 10-week, randomized, two-arm, double-masked, controlled clinical trial was conducted in 34 healthy, non-smoking females with plaque-induced gingivitis. Clinical periodontal examinations were repeated every other week. At week 4, test toothpaste containing 0.24% sodium monofluorophosphate, 0.3% triclosan, and 2% polyvinyl–methyl ether maleic acid; or control toothpaste containing 0.76% sodium monofluorophosphate and 0.1% sodium fluoride, were randomly distributed. Results: Multivariate multilevel models indicated that, after introducing experimental toothpastes, subject random error was reduced from 0.6 to below 0.2. The odds ratio (OR) of bleeding on probing (BOP) was about 30% less in the test than in the control group ( p<0.01). At the end of the experiment, ORs for BOP and plaque index scores 1–3 (reference 0) were 2.1–2.4 in the control group, but 1.1–1.9 in the test group ( p<0.05). No effects on plaque levels and calculus were observed. Conclusions: Multivariate multilevel modelling allows the study of fixed and random effects of experimental toothpastes on gingival inflammation in small sample. Triclosan appears to attenuate the causal association between supragingival plaque and gingival bleeding in gingivitis. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to determine the effect of various toothbrushing regimens with a standard fluoride dentifrice on the plaque inhibitory properties of an alcohol-free, high bioavailable 0.07% cetylpyridinium chloride (CPC) mouthrinse. Materials and Methods: The study was a randomized, single-centre, examiner blind, four-period cross-over study involving 29 healthy subjects. Four treatment regimens were evaluated: (1) Toothbrushing with dentifrice followed by a water rinse (B-W, negative control); (2) Toothbrushing with dentifrice followed by a CPC mouthrinse use (B-CPC); (3) Toothbrushing with dentifrice followed by a water rinse and then a CPC mouthrinse use (B-W-CPC); and (4) Toothbrushing with dentifrice and waiting 60 min. prior to a CPC mouthrinse use (B-60 min.-CPC). Three days before the baseline exam of treatment periods, subjects were instructed to brush only the lingual surfaces of their teeth for up to 60 s twice daily. At baseline, subjects received a plaque exam using the Turesky modification of the Quigley–Hein index (MQH) followed by a polishing on the lingual and buccal surfaces of their teeth. During treatment periods, subjects were asked to brush only the lingual surfaces of their teeth with a standard fluoride dentifrice. Rinsing with 20ml of the experimental CPC solution was done for 30 s twice daily. The evening before the last day of treatment periods (Day 4), subjects were asked to refrain from any oral hygiene, eating, and drinking after brushing. On Day 4, plaque was scored using the MQH Index. A 10-day wash-out of normal oral hygiene was allowed between each of the four treatment periods. The data were analysed using analysis of covariance for cross-over designs. Results: Twenty-five to 29 subjects were evaluable at any given visit. With respect to unbrushed buccal and brushed lingual surfaces, all three CPC regimens had highly significantly ( p⩽0.0006) lower mean plaque scores than the B-W regimen, reductions ranging from 20% to 38% in magnitude. With respect to unbrushed surfaces, there was a significant difference between the B-CPC regimen and the B-60 min.-CPC regimen ( p<0.01) in favour of the latter regimen. No other pairwise treatment comparisons were statistically significant for unbrushed sites. Results for brushed surfaces and all sites combined showed that both the B-W-CPC and the B-60 min.-CPC groups reduced mean plaque levels significantly ( p⩽0.013) more than B-CPC. There were no statistically significant differences between B-W-CPC and B-60 min.-CPC for measurements of brushed, unbrushed, or all sites combined. Conclusions: Results show that the alcohol-free, 0.07% high bioavailable CPC rinse provides an additive anti-plaque benefit beyond toothbrushing with a standard fluoride dentifrice regardless of the regimen. Of the regimens, a water rinse between toothbrushing and CPC rinsing enhances therapeutic efficacy while fitting into the patient's typical oral hygiene routine. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this experimental gingivitis study was to assess the efficacy and safety of two new chlorhexidine (CHX) mouthrinses. Materials and Methods: Ninety volunteers participated in this investigator-blind, randomized, clinical-controlled trial in parallel groups. During the treatment period, no oral hygiene measures except rinsing with non-alcoholic 0.2% CHX or 0.2% CHX/0.055% sodium fluoride mouthrinses, a positive control, or a negative control were permitted. The primary parameter was the gingival index; the secondary parameters were plaque index, discolouration index, and bleeding on probing. Clinical examinations were conducted 14 days before the start of the study, at baseline, and after 7, 14, and 21 days. The two sample t-test,anova, andancova were used for the statistical analysis. Results: No difference in efficacy was found between the two new CHX formulations and the positive control. On day 21, statistically significantly less gingival inflammation and plaque accumulation compared with placebo were observed. Besides discolouration and taste irritations, no adverse events were recorded. Conclusion: The two new CHX mouthrinses were able to inhibit plaque re-growth and gingivitis. Neither the omission of alcohol nor the supplementation with sodium fluoride had weakened the clinical efficacy of CHX with respect to the analysed clinical parameters. [ABSTRACT FROM AUTHOR]

Objectives: The aim of the present study was to compare the plaque-inhibitory effect of a 0.2% chlorhexidine digluconate (CHX) rinse when preceded by ordinary toothbrushing with a 1.5% sodium lauryl sulphate (SLS)-containing dentifrice to the effect of the same rinse when used alone, or when preceded by rinsing with an SLS-containing slurry. Methods: The study was an examiner blinded, randomized three-arm, parallel design. It used a 4-day plaque accumulation model to compare three different oral hygiene regimens, which were performed under supervision. One hundred and twenty healthy volunteers were enrolled in the study and were randomly assigned to one of each group. At the beginning of each test period, they received a thorough dental prophylaxis. The experiment was performed in one randomly assigned (upper or lower) jaw, called the study jaw. The opposite jaw, referred to as the dentifrice jaw, served only to introduce the influence of toothbrushing with a dentifrice on the anti-plaque efficacy of the CHX in the study jaw of the same mouth. At the end of the 4-day test period, plaque and gingival bleeding were scored in the study jaw. In all the regimens, the oral hygiene procedure was finalized by rinsing with a CHX 0.2% solution for 1 min. The study jaw was not brushed during the experiment. Regimen A (positive control) consisted of rinsing with CHX alone. In regimen B, rinsing with CHX was preceded by rinsing with an SLS-containing slurry, while in regimen C rinsing with CHX was preceded by toothbrushing with an SLS-containing dentifrice in the dentifrice jaw. No other oral hygiene measures were allowed. After 4 days of undisturbed plaque accumulation, the amount of plaque and level of gingival health were evaluated. Results: The overall plaque index for regimens A, B and C was 1.17, 1.62, and 1.14, respectively. There was no significant difference in plaque accumulation between the CHX alone regimen (A) and the SLS–dentifrice–CHX regimen (C). Regimen B differed significantly from regimens A and C. The overall bleeding index for regimens A, B and C was 0.24, 0.18, and 0.20, respectively. There was no significant difference between the three regimens. Conclusions: The present study shows that the anti-plaque efficacy of a 0.2% CHX rinse was not reduced when preceded by everyday toothbrushing with a SLS-containing dentifrice. However, when preceded by rinsing with an SLS-containing slurry, the anti-plaque efficacy of a 0.2% CHX rinse was reduced. [ABSTRACT FROM AUTHOR]

Aim: The present study aimed to evaluate if the oral cavity of chronic periodontitis patients can harbor Helicobacter pylori after systemic eradication therapy. Materials and Methods: Samples of 30 patients (15 with gingivitis and 15 with chronic periodontitis) positive for H. pylori in the stomach were evaluated. Samples were collected 3 months after triple systemic antibiotic therapy from saliva, microbiota from the dorsum of the tongue, supra- and sub-gingival plaque as well as gastric biopsies. DNA of each sample was extracted by the boiling method and used as a template in polymerase chain reaction with the primers JW22/23. Results: Eighteen patients (60%) harboured H. pylori in their mouths. Five patients (16.6%) were positive in saliva, two (6.6%) on the dorsum of the tongue, nine (30%) in supra-gingival plaque, 14 (46.6%) in sub-gingival plaque and three (10%) in the stomach. There was no statistically significant difference between study groups. Conclusion: Eradication of H. pylori after therapy was more effective for the stomach than for the mouth ( p<0.001). Mouths of patients with gingivitis or with chronic periodontitis, who are positive for H. pylori in their stomachs, may be considered as reservoirs of these bacteria. [ABSTRACT FROM AUTHOR]

Aim: To develop an improved method for quantitative assessment of antimicrobial efficacy and substantivity of mouth rinses and dentifrices on in vivo treated plaque. Material and Methods: Nine- and 72-h-old plaques were formed in volunteers carrying out standardized hygiene using NaF-containing dentifrice. Plaques were collected before (baseline) in vivo treatment with dentifrices or chlorhexidine mouth rinse, immediately post-treatment and after 1 or 6 h, dispersed in demineralized water and stained with live/dead stain after which bacteria were enumerated. Dispersed baseline plaques were treated with dentifrices or chlorhexidine to determine antimicrobial efficacy against planktonic bacteria. Results: Baseline plaques revealed 56–41% viable organisms in 9- and 72-h-old plaques, respectively. Treatment of planktonic (dispersed baseline plaque) bacteria resulted in 1–4% viable organisms. Chlorhexidine mouth rinse and dentifrices produced strong immediate antimicrobial effects, but after 1 or 6 h, the proportion of viable organisms in 9-h-old plaques rebounded significantly with only chlorhexidine mouth rinse retaining significant efficacy. Seventy-two-hour-old plaques were less susceptible to antimicrobials, although dentifrices appeared more effective after 6 h than initially, whereas efficacy of chlorhexidine rinse continued to drop with time post-treatment. Conclusions: The proposed method holds promise for assessment of both immediate and retained antimicrobial actions of oral treatments against dental plaque in vivo. [ABSTRACT FROM AUTHOR]

Aim: To review the literature on the effects of stannous fluoride on gingivitis. Material and Methods: The Medline and cochrane central register of controlled trials were searched up to August 2005 to identify appropriate studies. The primary outcome measure was gingivitis. Results: Independent screening of titles and abstracts of 542 papers resulted in 36 publications (inter-reviewer ê score of 0.76), out of which 15 papers finally fulfilled the criteria of eligibility. For SnF2 dentifrices, a statistically significant reduction in gingivitis was noted in comparison with control (weighted mean difference (WMD) of 0.15 (gingival index) and 0.21 (gingivitis severity index) (test for heterogeneity p<0.00001, I2=91.1% and p=0.03, I2=80.1%, respectively)). With regard to plaque reduction inconsistent results existed. On using the plaque index no differences were found, whereas meta-analysis of the Turesky index provided a WMD of 0.31 ( p=0.01, test for heterogeneity p<0.0001, I2=91.7%). Because of insufficient data, a meta-analysis for SnF2 mouth rinse and dentifrice/mouthrinse formulations was not performed. Conclusions: The use of SnF2 dentifrices results in gingivitis and plaque reduction when compared with a conventional dentifrice. The precise magnitude of this effect was difficult to assess because of a high level of heterogeneity in study outcomes. [ABSTRACT FROM AUTHOR]

Objective: To compare two sonic toothbrushes in relation to the reversal of experimental gingivitis. Materials and Methods: Subjects refrained from brushing mandibular teeth for 21 days. During a 4-week treatment phase, the right or left side of the mouth was brushed with either the Sonic Complete (SC) or Sonicare Elite (SE) toothbrush as randomly allocated. Plaque and gingivitis were assessed on day 0, after 21 days of no oral hygiene and after 1, 2 and 4 weeks of brushing twice daily. Results: Thirty-four subjects provided evaluable data. The experimentally induced gingivitis (EIG) resulted in higher bleeding and plaque scores compared with day 0. The mean plaque scores at day 21 changed from 3.09 to 1.30 for the SC, and from 3.02 to 1.21 for the SE. At the end of the treatment period, there was no significant difference between the two brushes. The mean bleeding scores changed from 1.87 (day 21) to 0.97 for the SC, and from 1.83 to 0.92 for the SE. For the assessments at 1, 2 and 4 weeks post-EIG, both brushes showed a significant decrease in bleeding scores. There were no statistically significant differences between brushes. [ABSTRACT FROM AUTHOR]

Objective: To assess the effectiveness of self-performed mechanical plaque removal in adults with gingivitis using a manual toothbrush with respect to the level of plaque and gingivitis in controlled studies of at least 6 months duration. Search: Medline-PubMed up to and including September 2004. Results: Out of 3223 titles and abstracts, 33 trials were found for data extraction. A meta-analysis was conducted of studies ( n=9) in which, for the manual toothbrush group at baseline, only a professional prophylaxis provided. The weighted mean differences (WMD) between baseline and end-trial for the Quigley & Hein plaque index was 0.28 and 0.21 for the Gingival Index ( p<0.05). Eight studies provided both a professional OHI and prophylaxis at baseline. The WMD for the Silness & Löe Plaque Index was 0.10 (ns). The WMD of the proportion of bleeding sites was 5.84% ( p<0.05). Conclusion: In adults with gingivitis the quality of self-performed mechanical plaque removal is not sufficiently effective and should be improved. Based on studies ⩾6 months of duration, it appears that a single oral hygiene instruction, describing the use of a mechanical toothbrush, in addition to a single professional ‘oral prophylaxis’ provided at baseline, had a significant, albeit small, positive effect on the reduction of gingivitis. [ABSTRACT FROM AUTHOR]

Introduction: This study was undertaken to test the hypothesis that male, non- smokers, aged 25-50 years, with a proven track record of developing gingivitis would provide suitable subjects for experimental gingivitis studies because the inter-subject variation would be greatly reduced. Materials and Methods: Subjects were required to be men aged between 25 and 50 years, in good general health with at least four sound teeth in one posterior quadrant of the mandible. Subjects who were smokers, taking antibiotics, anti-inflammatory thugs or had any other medical, surgical or social condition making participation in the study inadvisable, were excluded. Subjects had previously participated in a 21-day experimental gingivitis study. Subjects with the most gingivitis at the end of the previous study were invited to participate first, moving down the list until the required number of subjects had been achieved. Subjects were randomly assigned to one of three toothpastes: Crest Gum Care, Mentadent P or a placebo (UK Signal). Subjects were asked to brush their teeth twice daily for 1 mm., with the tooth-shield in place and containing 1 ml of their assigned toothpaste. Results: Thirty-five subjects completed the study using the placebo, 36 used Mentadent P and 39 completed the study using Crest Gum Care. Both toothpastes containing active gum health ingredients (Triclosan and Zinc Citrate in Mentadent P and Stannous Fluoride in Crest Gum Care) resulted in statistically significant reductions in gingival bleeding and inflammation. Although a directional reduction, there was no statistically significant reduction in plaque scores. No significant differences between the two active groups were established. Conclusion: The factors that were controlled or measured and analyzed in these studies were: gender, smoking status, age and chronic gingivitis level. The results add support to the hypothesis that male subjects show less variation, however there is limited evidence linking the female menstrual cycles to variations in gingivitis status. Further research in this area is required before definitive conclusions can be made. Selecting a subject population in order to decrease variation must be undertaken with caution. A subject population selected for particular attributes can be extremely valuable when assessing the anti-gingivitis potential of new agents, but this population would be as biased if used for large efficacy clinical trials. The data obtained will not necessarily be able to be generalized, that is, applicable to the whole population. However there is sufficient evidence to justify balancing for (or excluding) smokers from subject populations in experimental gingivitis studies. [ABSTRACT FROM AUTHOR]

Aim: To examine the effect of amine fluoride/stannous fluoride (AmF/SnF2)- containing dentifrice and mouth rinse on plaque formation and gingivitis as compared with habitual oral hygiene procedures with a regular sodium fluoride (NaF) dentifrice. Material and Methods: In total, 22 general practices participated in this research project. The participants (N 281) were randomly assigned into two groups: the test group received an AmF/SnF2 dentifrice-mouth rinse combination and the control group received a NaF-containing dentifrice. The patients were requested to brush twice daily for approximately 2 mm. The subjects of the test group had to rinse additionally in the evening for 30s with 10 ml of the mouth rinse. Results: Both groups started with comparable scores of plaque, bleeding and staining. At 6 months, the plaque scores were 0.95 for the AmF/SnF2 group and 0.99 for the NaF group (decrease of 16% and 10%, respectively). Bleeding scores, although significantly different from baseline, did not show differences between the two regimes. At the end of the experimental period, the overall staining was more pronounced in the AmF/SnF2 group (4 1%) than the NaF group (26%). Both plaque reduction and increase in staining seemed to be correlated to the amount of mouth rinse used in the test group. Conclusion: In instruction-resistant patients recruited from dental practices, the combined use of AinF/SnF2 did not decrease gingivitis at a significant level in comparison with the regular regime of two times daily brushing with an NaF- containing dentifrice. However, the above-mentioned combination resulted in greater plaque reduction than that observed with the use of the conventional dentifrice. When used according to the manufacturer's instructions, this effect on plaque scores was more pronounced. [ABSTRACT FROM AUTHOR]

Claydon NC, Addy M, Newcombe R, Moran J. The prevention of plaque re-growth by toothpastes and solutions containing block copolymers with and without polypeptide. J Clin Periodontol 2005; doi: 10.1111/j.1600-051X.2005.00709.x.© Blackwell Munksgaard, 2005.Chemicals which have a direct effect at inhibiting or reducing bacterial adherence to tooth surfaces may subsequently inhibit plaque growth and reduce gingival inflammation. This study investigated whether two anti-adherent systems could inhibit plaque re-growth in the mouth when rinsed as a solution or as a toothpaste slurry.A total of 21 subjects took part in a partially blind, seven cell cross-over study which compared the effects on plaque re-growth of a binary system containing block copolymers, a ternary system containing block copolymers and polypeptide, both used as toothpaste slurry rinses, their corresponding solution rinses, a conventional fluoride toothpaste rinse, a positive control chlorhexidine rinse and a negative water control. Following a dental prophylaxis subjects then rinsed with 10 ml of one of the test products for 1 min. twice a day over a 4-day period. Throughout each trial period the subjects were not permitted to use any other forms of oral hygiene. On the fifth day (96 h), the volunteers returned to the clinic, and plaque was assessed by (1) plaque index and (2) plaque area following disclosing with a food dye. The test phase of the trial was repeated for each agent and was followed by a 10-day“washout” period.Essentially neither of the anti-adherent systems inhibited plaque re-growth, whether administered in a toothpaste slurry or solution compared with the controls. If anything, neither of the test pastes were as effective as the marketed commercial paste (p<0.001). As expected plaque recorded following use of the chlorhexidine rinse was significantly less than that seen with any of the other rinses (p<0.001).Using this 4-day plaque re-growth model, the findings of this study failed to show any benefit in using the anti-adherent systems, either in a rinse or toothpaste, with the aim of inhibiting or reducing plaque formation. [ABSTRACT FROM AUTHOR]

Almerich JM, Cabedo B, Ortolá JC, Poblet J. Influence of alcohol in mouthwashes containing triclosan and zinc: an experimental gingivitis study.J Clin Periodontol 2005; doi:10.1111/j.1600-051X.2005.00675.x.© Blackwell Munksgaard, 2005.An experimental gingivitis model was used to analyse the influence of alcohol in mouthwashes containing 0.15% triclosan and zinc chloride on the formation of supragingival plaque, the development of gingivitis and the appearance of adverse events.Using a double-blind crossover design, 30 subjects underwent two consecutive experimental phases with two 0.15% triclosan and zinc chloride mouthwashes, differentiated mainly by their excipient (hydroalcoholic or aqueous). In each phase, the subjects discontinued all oral hygiene measures and were treated solely with the randomly assigned experimental mouthwash for 21 days. Each experimental phase was preceded by a 14-day washout period in which, after receiving a complete oral prophylaxis, the subjects were instructed to perform thorough oral hygiene procedures. Gingivitis and plaque levels were assessed at the start and end of both the experimental phases.The evolution of the gingivitis and plaque indices showed no statistically significant differences between both treatments. The mean gingival index increased from 0.30 to 0.38 with the non-alcoholic mouthwash and from 0.32 to 0.42 with the hydroalcoholic mouthwash. The respective changes in plaque index were from 0.88 to 1.93 and from 0.94 to 1.92. The hydroalcoholic mouthwash produced a larger number of fresh symptoms (p=0.033), oral itching being the most reported.Alcohol does not influence the effectiveness of a 0.15% triclosan and zinc chloride mouthwash against gingivitis development and supragingival plaque formation. The absence of alcohol significantly decreases the incidence of adverse events produced by the mouthwash. [ABSTRACT FROM AUTHOR]

Rosin M, Kähler ST, Hessler M, Schwahn Ch, Kuhr A, Kocher T. The effect of a dexibuprofen mouth rinse on experimental gingivitis in humans. J Clin Periodontol 2005; 32: 617–621. doi: 10.1111/j.1600-051X.2005.00721.x.© Blackwell Munksgaard, 2005.The pharmacodynamic properties of ibuprofen are related nearly exclusively to theS(+)enantiomer (dexibuprofen). This study investigated the effect of a 1.5% dexibuprofen mouth rinse in an experimentally induced gingivitis.The trial was a randomized, double-blinded, placebo-controlled, two-period and two-sequence parallel group cross-over study in 24 healthy volunteers aged 21–30 years (16 males, eight females). Customized guards were worn during tooth brushing to prevent any plaque removal from the experimental area (first and second pre-molars and molars in one upper quadrant). After 22 days of plaque accumulation, the mouth rinses (1.5% dexibuprofen and placebo) were administered under supervision three times daily (rinsing for 1 min. with 15 ml) for 8 days. The wash-out time between the two study periods was 14 days. Parameters evaluated at days 0, 7, 14, 22, and 30 were the Löe&Silness gingival index (GI) and the Quigley&Hein plaque index (QHI). Data were tested for treatment, period, and carry-over effects (parametric cross-over analysis).There was no statistically significant difference (p=0.240) in GI between placebo and dexibuprofen. However, the decrease in QHI was significantly greater (p=0.019) with dexibuprofen as compared with the placebo.In the present study, a 1.5% dexibuprofen mouth rinse had no effect on gingivitis whereas an anti-plaque effect was demonstrated. [ABSTRACT FROM AUTHOR]

Paraskevas S, Danser MM, Timmerman MF, Van der Velden U, van der Weijden G A. Optimal rinsing time of intra-oral distribution (spread) of mouthwashes. J Clin Peridontol 2005; 32: 665–669. doi: 10.1111/j.1600–051X.2005.00731.x.© Blackwell Munksgaard, 2005.To investigate the intra-oral spread of an erythrosine mouthwash in relation to the rinsing period.Thirty subjects were randomly divided into two equal groups and asked to rinse with 10 ml erythrosine mouthwash for cumulative periods of 15, 30 and 60 s (Group I) and 30, 60 and 90 s (Group II). Each rinsing session was followed by new plaque measurements. After rinsing plaque was finally assessed using the erythrosine mouthwash applied by means of a cotton swab.In Group I there was a difference observed between the 15 s rinsing period and those of 30 and 60 s. Explorative analysis for Group I suggested that differences in both jaws and approximal sites on both vestibular and lingual surfaces appeared to have contributed to the overall difference seen between 15 and 30 s rinsing periods. Also, pre-molars and front teeth seem to have contributed to this observed difference. No differences were noted between rinsing sessions and cotton swab application for Group II or Groups I+II combined.Rinsing for 30 s appeared to be sufficient for all plaque-covered surfaces of the dentition to come into contact with the mouthwash. [ABSTRACT FROM AUTHOR]

Welk A, Splieth CH, Schmidt-Martens G, Schwahn Ch, Kocher Th, Kramer A, Rosin M: The effect of a polyhexamethylene biguanide mouthrinse compared with a triclosan rinse and a chlorhexidine rinse on bacterial counts and 4-day plaque re-growth. J Clin Periodontol 2005; 32: 499–505. doi: 10.1111/j.1600-051X.2005.00702.x.© Blackwell Munksgaard, 2005.For various clinical applications, polyhexamethylene biguanide hydrochloride (PHMB) has been used for many years as an antiseptic in medicine. Recently, a 0.04% and a 0.12% PHMB mouthwash were shown to inhibit plaque re-growth and to reduce oral bacterial counts. In this study, a 0.2% PHMB mouthrinse (A) was compared with a positive control 0.12% aqueous chlorhexidine solution (B), a commercially available 0.3% triclosan/2.0% polyvinyl methyl ether maleic acid copolymer mouthrinse (Colgate Total Plax®) (C), and a negative control placebo rinse (10% ethanol, flavour) (D).The controlled clinical study was a double blind, randomized, four replicate cross - over design. Plaque re-growth was assessed with the Turesky et al. (1970) modification of the Quigley&Hein (1962) plaque index. The antibacterial effect was assessed by taking bacterial counts on the tooth surface (smears from the buccal surface of 16/26) and mucosa (smears from the buccal mucosa in opposite of area 16/26) after the professional prophylaxis and after the first rinse with the preparations on day 1 and prior to the clinical examination on day 5. Sixteen volunteers participated and, on day 1 of each study period were rendered plaque-free, ceased toothcleaning, and rinsed twice daily with the allocated mouthrinse. On day 5, plaque was scored and smears were collected according to the protocol. A 10-day wash-out period was carried out between each rinse evaluation. Data were analysed usingancovawith Bonferroni HSD adjustment for multiple comparisons (colony forming units per sample) with a significance levelα=0.05.The 0.2% PHMB mouthrinse (A) was significantly better at inhibiting plaque than the placebo (D), but significant less effective than the 0.12% aqueous chlorhexidine solution (B). There is no significant difference between A and the 0.3% triclosan/2.0% copolymer mouthrinse (C).Bacterial count reductions (tooth surface and mucosa) with PHMB (A) were significantly greater compared with the placebo (D) and triclosan (C), but significantly lower compared with chlorhexidine (B) (tooth surface) and equally effective compared with chlorhexidine (B) (mucosa).Consistent with previous studies, a PHMB mouthrinse was shown to inhibit plaque re-growth and to reduce oral bacterial counts, indicating that PHMB could be an alternative to established mouthrinses in preventive applications. [ABSTRACT FROM AUTHOR]

Quirynen M, Soers C, Desnyder M, Dekeyser C, Pauwels M, van Steenberghe D. A 0.05% cetyl pyridinium chloride/0.05% chlorhexidine mouth rinse during maintenance phase after initial periodontal therapy. J Clin Periodontol 2005; 32: 390–400. doi: 10.1111/j.1600-051X.2005.00685.x.© Blackwell Munksgaard, 2005.Chlorhexidine (CHX) mouth rinse/spray can still be considered the gold standard in the chemical prevention of plaque formation and development of gingivitis. The product unfortunately has some side effects, such as extrinsic tooth staining, poor taste, taste disturbance, sensitivity changes in tongue, pain and irritation because of the alcohol content. These side effects led to the search of new formulations.In this double-blind, randomized, long-term, parallel study, 48 moderate periodontitis patients rinsed for 6 months (starting immediately after a“one-stage, full-mouth” disinfection) with one of the following products: CHX 0.2%+alcohol (Corsodyl®), CHX 0.05%+ cetyl pyridinium chloride (CPC) 0.05% and no alcohol (Perio-Aid Maintenance®, a new formulation), or the placebo of the latter. After 1, 3 and 6 months a series of clinical and microbiological parameters were recorded for the supra- and subgingival area as well as for saliva.Although there was a significant treatment impact (mechanical debridement) in all groups, both CHX solutions further decreased both plaque and gingivitis indices (p<0.001 andp<0.05, respectively), when compared with placebo. This was also reflected by additional reductions in the number of CFU/ml of aerobic and especially anaerobic species and by a suppression ofStreptococcus mutans(versusan overgrowth for the placebo), in all niches. Differences between both CHX solutions were never encountered. The subjective ratings were slightly in favour of the new CHX–CPC formulation when compared with the other CHX–alcohol formulation, especially for taste of the product (p<0.05), but less impressive for the staining of teeth and tongue.The results of this study demonstrated the potential of a new CHX 0.05%+CPC 0.05% non-alcoholic formulation as an effective antiplaque agent for long-term use with reduced subjective side effects. [ABSTRACT FROM AUTHOR]

Van Strydonck DAC, Timmerman MF, van der Velden U, van der Weijden GA: Plaque inhibition of two commercially available chlorhexidine mouthrinses. J Clin Periodontol 2005; 32: 305–309. doi: 10.1111/j.1600-051X.2005.00681.x.© Blackwell Munksgaard, 2005.Chlorhexidine (CHX) 0.2% solution is still“the leading oral antiseptic” for controlling gingivitis. Side effects, however, limit the acceptability to users and the long-term employment of a 0.2% CHX antiseptic in preventive dentistry. This stimulated the development of new formulations. The aim of the present study was to assess the effect on plaque inhibition and taste perception of two commercially available mouthrinses (0.12% CHX non-alcohol base with 0.05% cetyl pyridinium chloride (Cpc)versus0.2% CHX alcohol base).The study was designed as a single-blind, randomized two group parallel experiment, to compare two different commercially available mouthrinses, during a 3-day plaque accumulation model. Forty healthy volunteers were enrolled in the study and received a thorough dental prophylaxis at the beginning of the test period. Over a 72-h experimental non-brushing period, during which subjects abstained from all forms of mechanical oral hygiene, one group (test) used a 15 ml alcohol free 0.12% CHX (=18 mg) mouthrinse on a Cpc base (Perioaid®, CHX⊕Cpc), twice daily for 30 s. The other group (control) used a 10 ml 0.2% CHX (=20 mg) mouthrinse on an 11.8% ethanol alcohol base (Corsodyl®, CHX⊕Alc), twice daily for 60 s. After 72 h of plaque formation, the amount of plaque was evaluated. By the use of visual analogue scale, the subjects were asked for their appreciation of the taste of the mouthrinse they had used.The mean plaque index for the CHX⊕Cpc group was 0.97 and for the CHX⊕Alc group 0.78. After 72 h of non-brushing, there was no significant difference in plaque accumulation between the two groups. The answers to the questions (taste perception and after-taste) showed a statistically significant difference between the two groups. The mean visual analogue scale (VAS) scores for taste appreciation on a scale from very bad to very good taste (0–10) were 5.92 for the CHX⊕Cpc group and 4.10 for the CHX⊕Alc group (p=0.02). The mean visual analogue scale (VAS) scores for the after-taste on a scale from very short to very long (0–10) were 7.24 for the CHX⊕Cpc group and 5.38 for the CHX⊕Alc group.Within the limitations of the present study design, it can be concluded that rinsing with a 0.12% CHX mouthrinse on a non-alcohol base with 0.05% Cpc (Perio-Aid®) is not significantly different from rinsing with a 0.2% CHX mouthrinse on an alcohol base (Corsodyl®). It appears that the subjects appreciated the taste of the non-alcohol CHX solution better but the after-taste of the rinse remained longer in the mouth. [ABSTRACT FROM AUTHOR]

Haffajee AD, Japlit M, Bogren A, Kent Jr RL, Goodson JM, Socransky SS: Differences in the subgingival microbiota of Swedish and USA subjects who were periodontally healthy or exhibited minimal periodontal disease. J Clin Periodontol 2005; 32: 33–39. doi: 10.1111/j.1600-051X.2004.00624.x.© Blackwell Munksgaard, 2005.Previous studies have shown differences in the mean proportions of subgingival species in samples from periodontitis subjects in different countries, which may relate to differences in diet, genetics, disease susceptibility and manifestation. The purpose of the present investigation was to determine whether there were differences in the subgingival microbiotas of Swedish and American subjects who exhibited periodontal health or minimal periodontal disease.One hundred and fifty eight periodontally healthy or minimally diseased subjects (NSweden=79; USA=79) were recruited. Subjects were measured at baseline for plaque, gingivitis, BOP, suppuration, pocket depth and attachment level at 6 sites per tooth. Subgingival plaque samples taken from the mesial aspect of each tooth at baseline were individually analyzed, in one laboratory, for their content of 40 bacterial species using checkerboard DNA–DNA hybridization (total samples=4345). % DNA probe counts comprised by each species was determined for each site and averaged across sites in each subject. Significance of differences in proportions of each species between countries was determined usingancovaadjusting for age, mean pocket depth, gender and smoking status.pvalues were adjusted for multiple comparisons. Cluster analysis was performed to group subjects based on their subgingival microbial profiles using a chord coefficient and an average unweighted linkage sort.On average, all species were detected in samples from subjects in both countries. After adjusting for multiple comparisons, 5 species were in significantly higher adjusted mean percentages in Swedish than American subjects:Actinomyces naeslundiigenospecies 1 (9.7, 3.3);Streptococcus sanguis(2.5, 1.2);Eikenella corrodens(1.7, 1.0);Tannerella forsythensis(3.5, 2.3) andPrevotella melaninogenica(6.3, 1.8).Leptotrichia buccaliswas in significantly higher adjusted mean percentages in American (5.5) than Swedish subjects (3.0). Cluster analysis grouped 121 subjects into 8 microbial profiles. Twenty four of the 40 test species examined differed significantly among cluster groups. Five clusters were dominated by American subjects and 2 clusters by Swedish subjects. Fifty eight of 79 (73%) of the Swedish subjects fell into 1 cluster group dominated by high proportions ofA. naeslundiigenospecies 1,Prevotella nigrescens, T. forsythensisandP. melaninogenica. Other clusters were characterized by high proportions ofActinomyces gerencseriae, Veillonella parvula, Capnocytophaga gingivalis, Prevotella intermedia, Eubacterium saburreum, L. buccalisandNeisseria mucosa.The microbial profiles of subgingival plaque samples from Swedish and American subjects who exhibited periodontal health or minimal disease differed. The heterogeneity in subgingival microbial profiles was more pronounced in the American subjects, possibly because of greater genetic and microbiologic diversity in the American subjects sampled. [ABSTRACT FROM AUTHOR]

Wara-aswapati N, Krongnawakul D, Jiraviboon D, Adulyanon S, Karimbux N, Pitiphat W: The effect of a new toothpaste containing potassium nitrate and triclosan on gingival health, plaque formation and dentine hypersensitivity. J Clin Periodontol 2004; doi: 10.1111/j.1600-051X.2004.00631.x.© Blackwell Munksgaard, 2004.The purpose of this study was to investigate the effect of a new toothpaste containing an antiplaque and antiinflammatory agent (0.3% triclosan), a desensitizing agent (5% potassium nitrate) and an anticaries agent (0.76% sodium monofluorophosphate (SMFP)) on gingival health, plaque formation and dentine hypersensitivity in a 12-week home study. The efficacy of the test toothpaste was compared with that of a control toothpaste containing 5% potassium nitrate and 0.76% SMFP and a benchmark product containing only 0.76% SMFP.One hundred and two healthy volunteers, who had a minimum of 20 natural permanent teeth with no probing depth>4 mm and at least one sensitive tooth, participated in this study. Following enrollment, the subjects received a dental prophylaxis and instruction in brushing technique. After a 4-week pre-experimental phase, baseline gingival bleeding index (GBI), plaque index (PI) and visual analogue scales (VASs) indicating dentine hypersensitivity levels responding to tactile and air stimuli were assessed. The subjects were then randomly given one of the three toothpastes; test, control, or benchmark toothpaste, and a soft-filamented toothbrush for home use. The GBI, PI and VASs were re-examined at weeks 4 and 12.Overall, the GBI scores were significantly reduced compared with baseline in all groups (p<0.01). However, there was no significant difference in GBI score among the three comparison groups. The PI score decreased in the test group and benchmark group from baseline to the end of study, whereas there was no significant change in the control group. Post hoc comparison indicated that the PI score was not statistically different between the three groups. There was a significant difference between the three treatment groups for sensitivity. For both the tactile and air stimuli, the reductions in VAS sensitivity scores for the test group and the control group were significantly greater compared with the benchmark group. Although the sensitivity score for air stimulus decreased more rapidly from baseline to week 4 in the test group, there was no overall difference between the test group and the control group.This study demonstrated that the new toothpaste was effective in reducing dentine hypersensitivity. More studies are needed to further determine the potential interaction between triclosan and potassium nitrate in dentifrices. [ABSTRACT FROM AUTHOR]

Van der Weijden GA, Timmerman MF, Novotny AGA, Rosema NAM, Verkerk AAJ. Three different rinsing times and inhibition of plaque accumulation with chlorhexidine. J Clin Periodontol 2004; doi:10.1111/j.1600-051x.2004.00640.x.© Blackwell Munksgaard, 2004.This study assessed the plaque inhibiting effect of a 0.2% chlorhexidine (CHX) solution (Corsodyl®) with three different rinsing times following a 72 h non-brushing period.The clinical investigation was a single-blind, randomised study involving 90 volunteer students (40 male and 50 female, mean age 23.2 years). Subjects were randomly allocated to one of three groups for which the protocol only differed with respect to the duration of rinsing. At the start of the trial, all participants received a dental prophylaxis to remove all plaque deposits. Subjects refrained from all mechanical oral hygiene procedures, but rinsed two times per day for the allocated duration with CHX mouth rinse over a period of 72 h. The chlorhexidine preparation was of 0.2% concentration used at a dose of 10 ml for either 15, 30 or 60 s. After 72 h, the Quigley&Hein plaque index (PI) from all volunteers was recorded at six sites per tooth. All participants received a questionnaire to evaluate their perception of rinsing duration.After 72 h, the mean whole-mouth PI was 1.33, 1.18 and 1.24, respectively, for the 15, 30 and 60 s rinsing group. The difference in plaque scores between the three groups was not statistically significant. Results from the questionnaire showed a significant difference between the groups for their perception of rinsing duration.No significant difference was observed in the level of plaque after 72 h of non-brushing whether the subjects rinsed for 15, 30 or 60 s with 0.2% chlorhexidine. [ABSTRACT FROM AUTHOR]

Graveland MP, Rosema NAM, Timmerman MF, Van der Weijden GA: The plaque-removing efficacy of a finger brush (I-Brush®). J Clin Periodontol 2004; 31: 1084–1087. doi: 10.1111/j.1600-051X.2004.00607.x.© Blackwell Munksgaard, 2004.The purpose of the present study was to test the effectiveness of a finger toothbrush (I-Brush®) in removing plaque compared with a flat-trimmed manual toothbrush.For this study, 37 subjects were selected, without previous experience of the use of the I-Brush®. Each subject received a finger brush (I-Brush®), a manual toothbrush (Butler® GUM 311), two written brushing instructions for both types of brushes, and a brush calendar. Subjects were given a period of 3 weeks to become familiar with the two types of brushes. During this period, the subjects were instructed to use the two types of brushes on alternate days. The brush calendar helped as a reminder and served to ensure compliance. No instructions regarding brushing time or frequency of brushing were given to the subjects, except that they should conform to their usual oral habits. After 3 weeks, all subjects were asked to abstain from oral hygiene procedures for 48 h prior to the experiment. In this experiment, the amount of dental plaque was scored by a trained examiner. The examiner (N.A.M.R.) used the modifiedplaque index at six sites per tooth. After scoring, each subject received a new finger brush and a new manual toothbrush. The subjects brushed according to a split mouth protocol. Two contra-lateral quadrants were chosen randomly and were brushed with one randomly chosen brush and the two opposing contra-lateral quadrants with the alternate brush. The brushing was performed under supervision in front of a mirror. The available time for brushing was 2 min. for the entire dentition. Finally, the remaining plaque was scored again.The overall reduction in plaque was 79% for the manual toothbrush and 62% for the finger brush. The plaque removing efficacy of the finger brush was poorest at the approximal vestibular surfaces (55% plaque reduction) compared with the manual toothbrush (77% plaque reduction).The plaque reduction of the finger brush is not an acceptable alternative to the use of a regular manual toothbrush. [ABSTRACT FROM AUTHOR]

Claydon N, Yates R, Labello R, Hall C, Armstrong R, Addy M: A methodology using subjective and objective measures to compare plaque inhibition by toothpastes. J Clin Periodontol 2004; 31: 1106–1109. doi: 10.1111/j.1600-051X.2004.00610.x.© Blackwell Munksgaard, 2004.Plaque scoring usually employs subjective indices. The aim was to compare plaque inhibition of three toothpastes using two objective and one subjective measures of plaque.Formulations were: (1) an experimental anti-plaque paste (test); (2) an experimental paste (minus active or negative control); and (3) a proprietary anti-plaque toothpaste product (positive control). The study was a blind, randomised crossover design using a 4-day, no tooth brushing, plaque regrowth model and involving 22 healthy subjects. After baseline plaque removal, subjects rinsed twice a day with slurries of the allocated paste. On day 5, plaque was scored by index, wet weight and optical density of extracted disclosing solution from the plaque (stain intensity).All data showed the same pattern. There were highly significant subject and treatment effects but not period effects. The positive control was highly significantly more effective in plaque control than the test and minus active experimental formulations, which in turn were not significantly different from each other. There were strong and significant correlations between pairs of scoring methods particularly wet weight and stain intensity.The use of objective methods of plaque alongside conventional subjective indices provided convincing evidence for increased discriminatory power in a study comparing plaque inhibition by toothpastes. [ABSTRACT FROM AUTHOR]

Davies RM, Ellwood RP, Davies GM: The effectiveness of a toothpaste containing Triclosan and PVM/MA in improving plaque control and gingival health. A systematic review. J Clin Periodontol 2004; 31: 1029–1033. doi: 10.1111/j.1600-051X.2004.00614.x.© Blackwell Munksgaard, 2004.To compare the effectiveness of triclosan/copolymer and fluoride dentifrices in improving plaque control and gingival health.We searched the Cochrane Controlled Trials Register, MEDLINE (1986 to March 2003) and EMBASE (1986 to March 2003). Personal files and the reference lists of all articles were checked for further studies.Trials were selected if they met the following criteria: random allocation of participants; participants were adults with plaque and gingivitis; unsupervised use of dentifrices for at least 6 months; and primary outcomes– plaque and gingivitis after 6 months.Two reviewers independently extracted information. For each plaque and gingivitis index, the mean differences for each study were pooled as weighted mean differences (WMDs) with the appropriate 95% confidence intervals (CIs) using the random effect models.Sixteen trials provided data for the meta-analysis. The triclosan/copolymer dentifrice significantly improved plaque control compared with a fluoride dentifrice, with a WMD of−0.48 (95% CI:−0.64 to−0.32) for the Quigley–Hein index and WMD of−0.15 (95% CI:−0.20 to−0.09) for the plaque severity index. When compared with a fluoride dentifrice, the triclosan/copolymer dentifrice significantly reduced gingivitis with WMDs−0.26 (95% CI:−0.34 to−0.18) and−0.12 (95% CI:−0.17 to−0.08) for the Loe and Silness index and gingivitis severity index, respectively. [ABSTRACT FROM AUTHOR]

Graveland MP, Rosema NAM, Timmerman MF, Van der Weijden GA: The plaque-removing efficacy of a finger brush (I-Brush®). J Clin Periodontol 2004; 31: 1084–1087. doi: 10.1111/j.1600-051X.2004.00607.x.© Blackwell Munksgaard, 2004.The purpose of the present study was to test the effectiveness of a finger toothbrush (I-Brush®) in removing plaque compared with a flat-trimmed manual toothbrush.For this study, 37 subjects were selected, without previous experience of the use of the I-Brush®. Each subject received a finger brush (I-Brush®), a manual toothbrush (Butler® GUM 311), two written brushing instructions for both types of brushes, and a brush calendar. Subjects were given a period of 3 weeks to become familiar with the two types of brushes. During this period, the subjects were instructed to use the two types of brushes on alternate days. The brush calendar helped as a reminder and served to ensure compliance. No instructions regarding brushing time or frequency of brushing were given to the subjects, except that they should conform to their usual oral habits. After 3 weeks, all subjects were asked to abstain from oral hygiene procedures for 48 h prior to the experiment. In this experiment, the amount of dental plaque was scored by a trained examiner. The examiner (N.A.M.R.) used the modifiedplaque index at six sites per tooth. After scoring, each subject received a new finger brush and a new manual toothbrush. The subjects brushed according to a split mouth protocol. Two contra-lateral quadrants were chosen randomly and were brushed with one randomly chosen brush and the two opposing contra-lateral quadrants with the alternate brush. The brushing was performed under supervision in front of a mirror. The available time for brushing was 2 min. for the entire dentition. Finally, the remaining plaque was scored again.The overall reduction in plaque was 79% for the manual toothbrush and 62% for the finger brush. The plaque removing efficacy of the finger brush was poorest at the approximal vestibular surfaces (55% plaque reduction) compared with the manual toothbrush (77% plaque reduction).The plaque reduction of the finger brush is not an acceptable alternative to the use of a regular manual toothbrush. [ABSTRACT FROM AUTHOR]

Paraskevas S, Danser MM, Timmerman MF, van der Velden U, van der Weijden GA: Amine fluoride/stannous fluoride and incidence of root caries in periodontal maintenance patients. A 2-year evaluation. J Clin Periodontol 2004; 31: 965–971. doi: 10.1111/j.1600-051X.2004.00593.x.© Blackwell Munksgaard, 2004.The purpose of the present study was to evaluate in a group of periodontal maintenance patients, the effect of using a dentifrice and mouthrinse containing amine fluoride (AmF) and stannous fluoride (SnF2) as compared with a dentifrice and mouthrinse both containing sodium fluoride (NaF) with regard to their root caries experience.In total, 80 patients who had been treated for moderate-to-severe periodontitis agreed to participate in this study. Subjects received supportive periodontal therapy at regular intervals of 3–4 months for at least a period of 1 year. The patients were randomly divided into two groups: (1) the test group used an AmF/SnF2 dentifrice and mouthrinse and (2) the control group used an NaF-containing dentifrice and mouthrinse. Root caries was recorded at four sites per tooth at baseline and 24 months.An increase in number of the exposed root surfaces was noted for both groups during the experimental period (p<0.05). The mean number of active caries lesions at baseline was 2.1 and 1.8 for the test group and control group, respectively. At 24 months, the corresponding values were 1.8 for the test and 2.2 for the control group. An increase of the mean number of restored surfaces was noted for the AmF/SnF2 group (from 7.3 to 13.4) and the control group (from 7.9 to 14.7) during the course of the study. This increase was found to be statistically significant for both groups in comparison with the baseline values (p⩽0.01). No statistically significant differences were noted between groups. Further analysis of the restored surfaces revealed that the major increase in number of the restorations was associated with restorations involving three to four root surfaces in the same tooth. Molars and premolars were the teeth receiving most new restorations.The present study did not detect a difference in terms of root caries development between the two groups. Root caries development is a common finding associated with surfaces developing recession in patients once treated for periodontal problems. [ABSTRACT FROM AUTHOR]